云南省0~3岁高危儿童发现及专案管理现状分析  

Analysis of the status quo of identification and project management of high-risk infants and toddlers ages 0-3 in Yunnan Province

作　　者：安艳婷 郭光萍[2] 郑佳瑞[2] 张晓雨 刘云芬 汤四意 车学继 AN Yanting;GUO Guangping;ZHENG Jiarui;ZHANG Xiaoyu;LIU Yunfen;TANG Siyi;CHE Xueji(School of Public Health,Kunming Medical University,Kunming Yunnan 650500,China;Yunnan Maternal and Child Health Care Hospital,Kunming Yunnan 650051,China)

机构地区：[1]昆明医科大学公共卫生学院,云南昆明650500 [2]云南省妇幼保健院,云南昆明650051

出　　处：《卫生软科学》2024年第3期85-90,共6页Soft Science of Health

基　　金：国家“十三五”科技重大专项(2018ZX10715006-004);云南省卫生健康委学科带头人专项(D-2019005)。

摘　　要：[目的]分析云南省0~3岁高危儿童发现率及主要高危因素、探索高危儿童专案管理影响因素,为提升高危儿童专案管理质量提供科学依据。[方法]采用多阶段分层随机抽样,于2022年10月-2023年4月,在抽中的云南省5个州市10家医疗保健机构,对前来进行儿童保健的2470例0~3岁儿童开展调查。通过查阅医疗文书获得高危儿童情况及专案管理情况,通过问卷调查儿童母亲获得高危儿童专案管理影响因素,采用单因素、多因素logistic回归方法分析。[结果]云南省0~3岁高危儿童发现率为29.92%,高危儿童专案管理率为44.52%。多因素logistic回归分析显示,成长期高危因素种类越多(OR=5.249)、新生儿期高危因素种类越多(OR=2.086)高危儿童被专案管理的可能性越大,但胎儿期高危因素种类越多(OR=0.444)高危儿童被专案管理的可能性越小。儿童分娩医疗保健机构级别为州市级及以上(OR=0.512)、医生未提醒家长带儿童体检(OR=0.313)、产科医生(OR=0.265)、新生儿科医生(OR=0.222)、儿童保健科医生(OR=0.038)未告知家长儿童是高危儿童为高危儿童专案管理的危险因素。[结论]云南省0~3岁高危儿童发现率高,专案管理率低,儿童高危因素发现的时期和种类、医疗保健机构对高危儿童专案管理质量是影响高危儿童专案管理的主要影响因素。Objective This paper analyzes the detection rate and main risk factors of high-risk infants and toddlers ages 0-3 in Yunnan Province,and influencing factors of project management for high-risk infants and toddlers to provide a scientific basis for improving the quality of project management for high-risk infants and toddlers.Methods A multi-stage stratified random sampling was used to investigate 2470 infants and toddlers ages 0-3 from October 2022 to April 2023 in ten health care institutions in five cities of Yunnan Province.The situation of high-risk infants and toddlers and the project management was obtained through medical documents.The influencing factors of the project management for high-risk infants and toddlers were obtained by distributing questionnaires to children’s mothers.Univariate and multivariate logistic regression analysis were adopted.Results The detection rate of high-risk infants and toddlers ages 0-3 was 29.92%,and the rate of the project management for high-risk infants and toddlers was 44.52%in Yunnan Province.Multivariate logistic regression analysis showed that possibilities of project management for high-risk infants and toddlers were big when there were more types of risk factors in the growth period(OR=5.249)and more types of risk factors in the neonatal period(OR=2.086).However,possibilities of project management for high-risk infants and toddlers were small when there were more types of risk factors in the fetal period(OR=0.444).Risk factors of project management for high-risk infants and toddlers were maternal and child health care institutions at the state level and above(OR=0.512),uninformed parents about children’s checkup(OR=0.313),and that obstetricians(OR=0.265),neonatologists(OR=0.222),and child health care specialists(OR=0.038)didn’t inform parents about high-risk infants and toddlers.Conclusions The detection rate of high-risk infants and toddlers ages 0-3 is high,but the rate of project management is low in Yunnan Province.The main influencing factors of project

关 键 词：高危儿童 专案管理 现状分析 

分 类 号：R197[医药卫生—卫生事业管理]